Chapter 30 EMT

1. A dysbarism injury refers to the signs and symptoms related to changes in:
A. rapid ascent.
B. rapid descent.
C. decompression.
D. barometric pressure.

Answer: D Question Type: General Knowledge Page: 1061

2. When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:
A. radiation.
B. conduction.
C. convection.
D. evaporation.

Answer: B Question Type: General Knowledge Page: 1062

3. The transfer of heat to circulating air, such as when cool air moves across the body’s surface, is called:
A. radiation.
B. conduction.
C. convection.
D. evaporation.

Answer: C Question Type: General Knowledge Page: 1062

4. The body’s natural cooling mechanism, in which sweat is converted to a gas, is called:
A. radiation.
B. convection.
C. conduction.
D. evaporation.

Answer: D Question Type: General Knowledge Page: 1062

5. Heat loss from the body through respiration occurs when:
A. warm air is exhaled into the atmosphere.
B. the core body temperature is greater than 98°F (37°C).
C. cool air is inhaled and displaces warm air.
D. air temperature is greater than body temperature.

Answer: A Question Type: General Knowledge Page: 1062

6. Shivering is a mechanism in which the body generates heat by:
A. increasing the metabolic rate.
B. decreasing the use of oxygen.
C. decreasing the metabolic rate.
D. retaining excess carbon dioxide.

Answer: A Question Type: General Knowledge Page: 1062

7. Covering a patient’s _________ will significantly minimize radiation heat loss.
A. head
B. chest
C. abdomen
D. extremities

Answer: A Question Type: General Knowledge Page: 1062

8. Hypothermia occurs when the core body temperature falls below:
A. 98°F (37°C).
B. 95°F (35°C).
C. 90°F (32°C).
D. 88°F (31°C).

Answer: B Question Type: General Knowledge Page: 1063

9. The body’s natural protective mechanisms against heat loss are:
A. shivering and vasodilation.
B. vasodilation and respiration.
C. respiration and vasoconstriction.
D. vasoconstriction and shivering.

Answer: D Question Type: General Knowledge Page: 1063

10. Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:
A. a decreased ability to shiver.
B. a relatively small surface area.
C. a smaller amount of body fat.
D. a smaller overall muscle mass.

Answer: B Question Type: General Knowledge Page: 1063

11. Which of the following conditions would be the LEAST likely to increase a person’s risk of hypothermia?
A. hypoperfusion
B. severe infection
C. hyperglycemia
D. spinal cord injury

Answer: C Question Type: General Knowledge Page: 1063

12. To assess a patient’s general temperature, pull back on your glove and place the back of your hand on his or her skin at the:
A. neck.
B. chest.
C. abdomen.
D. forehead.

Answer: C Question Type: General Knowledge Page: 1063

13. To obtain the MOST accurate reading of a patient’s core body temperature, you should place a special hypothermia thermometer:
A. into the patient’s rectum.
B. under the patient’s tongue.
C. behind the patient’s knee.
D. under the patient’s armpit.

Answer: A Question Type: General Knowledge Page: 1063

14. A patient with a core body temperature of 95°F (35°C) will MOST likely experience:
A. a slow pulse.
B. rapid breathing.
C. muscle stiffness.
D. loss of consciousness.

Answer: B Question Type: General Knowledge Page: 1063

15. Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?
A. bradypnea
B. confusion
C. stiff muscles
D. tachycardia

Answer: D Question Type: General Knowledge Page: 1063

16. A person’s ability to shiver is lost when his or her body temperature falls below:
A. 90°F (32°C).
B. 92°F (33°C).
C. 94°F (34°C).
D. 95°F (35°C).

Answer: A Question Type: General Knowledge Page: 1064

17. All of the following terms are used to describe a cold body part that is not frozen, EXCEPT:
A. frostnip.
B. frostbite.
C. chilblains.
D. trench foot.

Answer: B Question Type: General Knowledge Page: 1064

18. Patients with generalized hypothermia are at an increased risk of a local cold injury because:
A. blood is shunted away from the extremities to the body’s core.
B. peripheral vasodilation brings warm blood to the skin’s surface.
C. the major muscles of the body become rigid during hypothermia.
D. the patient is usually unable to escape the cold ambient temperature.

Answer: A Question Type: General Knowledge Page: 1065

19. A frostbitten foot can be identified by the presence of:
A. gross deformity.
B. soft, smooth skin.
C. mottling and blisters.
D. blanching of the skin.

Answer: C Question Type: General Knowledge Page: 1065

20. A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (−1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unconscious, pale, and apneic. You should:
A. apply an AED and assess his cardiac rhythm.
B. assess for a carotid pulse for up to 45 seconds.
C. open his airway and give two rescue breaths.
D. apply chemical heat packs to his groin and axillae.

Answer: B Question Type: Critical Thinking Page: 1066

21. Hypothermia can worsen internal bleeding secondary to:
A. cardiac arrhythmias.
B. a decreased heart rate.
C. severe muscular rigidity.
D. blood clotting abnormalities.

Answer: D Question Type: General Knowledge Page: 1067

22. Rough handling of a hypothermic patient with a pulse may cause:
A. profound bradycardia.
B. ventricular fibrillation.
C. ventricular tachycardia.
D. pulseless electrical activity.

Answer: B Question Type: General Knowledge Page: 1067

23. Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. In addition to monitoring her ABCs, administering oxygen, and turning up the heat in the back of the ambulance, you should:
A. apply the AED in case she develops cardiopulmonary arrest, cover her with layers of blankets, and transport carefully.
B. place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.
C. cover her with warm blankets and let her move about on the stretcher in order to generate body heat and increase her temperature.
D. sit her up and give her small sips of warm water to drink, place heat packs to her axillae and groin, and cover her with blankets.

Answer: B Question Type: Critical Thinking Page: 1068

24. You are transporting a 28-year-old man with a frostbitten foot. The patient’s vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:
A. rewarm his foot in 100°F to 105°F (38°C to 40°C) water.
B. administer oxygen via a nonrebreathing mask.
C. cover his foot with chemical heat compresses.
D. protect the affected part from further injury.

Answer: D Question Type: Critical Thinking Page: 1069

25. The two MOST efficient ways for the body to eliminate excess heat are:
A. respiration and bradycardia.
B. perspiration and tachycardia.
C. sweating and dilation of skin blood vessels.
D. hyperventilation and tachycardia.

Answer: C Question Type: General Knowledge Page: 1070

26. Which of the following MOST accurately describes hyperthermia?
A. The core body temperature exceeds 99.5°F (37°C).
B. The body is exposed to more heat than it can lose.
C. Heat evaporates a significant amount of body water.
D. The body eliminates more heat than it can generate.

Answer: B Question Type: General Knowledge Page: 1070

27. High air temperature reduces the body’s ability to lose heat by:
A. radiation.
B. convection.
C. conduction.
D. evaporation.

Answer: A Question Type: General Knowledge Page: 1070

28. Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:
A. have relatively smaller heads.
B. have less body fat.
C. exhibit poor thermoregulation.
D. have smaller body surface areas.

Answer: C Question Type: General Knowledge Page: 1070

29. When the body loses sweat, it also loses:
A. plasma.
B. nutrients.
C. erythrocytes.
D. electrolytes.

Answer: D Question Type: General Knowledge Page: 1070

30. In order for sweating to be an effective cooling mechanism:
A. several layers of clothing must be worn.
B. it must be able to evaporate from the body.
C. the relative humidity must be above 90%.
D. the body must produce at least 1 L per hour.

Answer: B Question Type: General Knowledge Page: 1070

31. High humidity reduces the body’s ability to lose heat through:
A. radiation.
B. convection.
C. conduction.
D. evaporation.

Answer: D Question Type: General Knowledge Page: 1070

32. Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:
A. nausea.
B. headache.
C. tachycardia.
D. hot, dry skin.

Answer: D Question Type: General Knowledge Page: 1071

33. Heatstroke occurs when:
A. a person’s core body temperature rises above 103°F (39°C).
B. the body’s heat-eliminating mechanisms are overwhelmed.
C. a person becomes dehydrated secondary to excess water loss.
D. the ambient temperature exceeds 90°F (32°C) and the humidity is high.

Answer: B Question Type: General Knowledge Page: 1071

34. Signs of late heatstroke include:
A. hot, moist skin.
B. nausea and vomiting.
C. a weak, rapid pulse.
D. a change in behavior.

Answer: C Question Type: General Knowledge Page: 1071

35. Which of the following medications increases a person’s risk of a heat-related emergency?
A. Motrin
B. Tylenol
C. Aspirin
D. diuretics

Answer: D Question Type: General Knowledge Page: 1072

36. You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. In addition to administering 100% oxygen, you should:
A. perform a rapid assessment and look for signs of trauma.
B. place him in a sitting position and have him drink 1 L of water.
C. load him into the ambulance and begin rapid cooling interventions.
D. administer one tube of oral glucose and reassess his mental status.

Answer: C Question Type: Critical Thinking Page: 1073

37. You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should:
A. give him a liquid salt solution to drink.
B. administer 100% supplemental oxygen.
C. apply chemical ice packs to his axillae.
D. move him into the cooled ambulance.

Answer: D Question Type: Critical Thinking Page: 1074

38. Geriatric patients are at a higher risk for heatstroke because:
A. circulation to the skin is reduced.
B. most geriatric patients are obese.
C. their ability to sweat is enhanced.
D. their ability to shiver is reduced.

Answer: A Question Type: General Knowledge Page: 1076

39. Drowning is MOST accurately defined as:
A. temporary survival after submersion in water.
B. death from suffocation after submersion in water.
C. water in the lungs following submersion in water.
D. death beyond 24 hours after submersion in water.

Answer: B Question Type: General Knowledge Page: 1076

40. Which of the following statements regarding drowning is correct?
A. Hypoxia in the drowning victim initially occurs due to water in the lungs.
B. Artificial ventilations can easily be performed in patients with a laryngospasm.
C. Large amounts of water enter the lungs in a small number of drowning victims.
D. Laryngospasm following submersion in water makes rescue breathing difficult.

Answer: D Question Type: General Knowledge Page: 1076

41. A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:
A. suction his airway for 30 seconds, provide rescue breathing, keep him warm, and transport at once.
B. ventilate with a bag-mask device, apply a cervical collar, remove his wet clothing, and transport rapidly.
C. provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully.
D. apply 100% oxygen via a nonrebreathing mask, immobilize his spine, keep him warm, and transport rapidly.

Answer: C Question Type: Critical Thinking Page: 1076

42. The EMT must assume that any unwitnessed water-related incident is accompanied by:
A. an air embolism.
B. alcohol intoxication.
C. possible spinal injury.
D. cold water immersion.

Answer: C Question Type: General Knowledge Page: 1076-1077

43. You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:
A. move him as a unit to a supine position.
B. begin ventilations with a barrier device.
C. immediately secure him to a longboard.
D. perform a jaw-thrust maneuver to open his airway.

Answer: A Question Type: Critical Thinking Page: 1078

44. The diving reflex may allow a person to survive extended periods of submersion in cold water secondary to:
A. bradycardia and a slowing of the metabolic rate.
B. laryngospasm that protects the lungs from water.
C. tachycardia and a lowering of the blood pressure.
D. increases in the metabolic rate and oxygen demand.

Answer: A Question Type: General Knowledge Page: 1079

45. Most of the serious injuries associated with scuba diving are caused by:
A. water temperature lower than 70°F (21°C).
B. too rapid of a descent.
C. alcohol consumption.
D. too rapid of an ascent.

Answer: D Question Type: General Knowledge Page: 1080

46. An air embolism associated with diving occurs when:
A. the diver hyperventilates prior to entering the water.
B. the diver holds his or her breath during a rapid ascent.
C. the alveoli completely collapse due to high pressure.
D. high water pressure forces air into the mediastinum.

Answer: B Question Type: General Knowledge Page: 1080

47. Signs and symptoms of an air embolism include all of the following, EXCEPT:
A. dysphasia.
B. pale skin.
C. dizziness.
D. joint pain.

Answer: B Question Type: General Knowledge Page: 1080

48. The MOST prominent symptom of decompression sickness is:
A. tightness in the chest.
B. difficulty with vision.
C. dizziness and nausea.
D. abdominal or joint pain.

Answer: D Question Type: General Knowledge Page: 1080

49. You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30′. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:
A. suction his mouth and nose, apply high-flow oxygen, position him on his left side with his head down, and contact medical control regarding transport to a recompression facility.
B. place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department.
C. suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his brain, administer high-flow oxygen, and transport to a hyperbaric chamber.
D. position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-mask device, and contact medical control for further guidance.

Answer: A Question Type: Critical Thinking Page: 1084

50. Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when:
A. a swimmer breathes shallowly before entering the water.
B. a diver holds his or her breath during a staged ascent.
C. a swimmer hyperventilates prior to entering the water.
D. a diver holds his or her breath for a long period of time.

Answer: C Question Type: General Knowledge Page: 1084

51. Burns associated with lightning strikes are typically:
A. superficial.
B. third-degree.
C. full-thickness.
D. partial-thickness.

Answer: A Question Type: General Knowledge Page: 1085

52. Which of the following statements regarding lightning strikes is correct?
A. Lighting often results in a brief period of asystole that resolves spontaneously.
B. The tissue damage pathway caused by lightning usually occurs through the skin.
C. Victims who are struck by lightning often experience severe full-thickness burns.
D. Cervical spine fractures are the most common cause of lightning-related deaths.

Answer: A Question Type: General Knowledge Page: 1085

53. You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:
A. immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment.
B. focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest.
C. assess the unresponsive patient’s pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.
D. recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries.

Answer: C Question Type: Critical Thinking Page: 1085

54. The venom of a black widow spider is toxic to the:
A. renal system.
B. nervous system.
C. respiratory system.
D. cardiovascular system.

Answer: B Question Type: General Knowledge Page: 1086

55. In contrast to the brown recluse spider, the black widow spider:
A. is very small and has a violin-shaped marking on its back.
B. is large and has a red-orange hourglass mark on its abdomen.
C. has a bite that is typically painless until a blister develops.
D. has a bite that usually produces local pain but no systemic signs or symptoms.

Answer: B Question Type: General Knowledge Page: 1086

56. The venom of a brown recluse spider is cytotoxic, meaning that it:
A. suppresses the respiratory drive.
B. destroys the body’s red blood cells.
C. weakens the structure of the bones.
D. causes severe local tissue damage.

Answer: D Question Type: General Knowledge Page: 1086

57. You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient’s abdomen is rigid and painful to palpation. You should suspect:
A. a black widow spider bite.
B. envenomation from a pit viper.
C. a brown recluse spider bite.
D. Rocky Mountain spotted fever.

Answer: A Question Type: Critical Thinking Page: 1086

58. All of the following snakes are pit vipers, EXCEPT for the:
A. copperhead.
B. rattlesnake.
C. coral snake.
D. cottonmouth.

Answer: C Question Type: General Knowledge Page: 1088

59. Which of the following is an early sign of pit viper envenomation?
A. local swelling and ecchymosis
B. general weakness and diaphoresis
C. syncope and bleeding at distal sites
D. signs and symptoms of hypoperfusion

Answer: A Question Type: General Knowledge Page: 1089

60. While drinking beer with his friends near a creek, a 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:
A. applying ice to the wound and transporting quickly.
B. transporting only with close, continuous monitoring.
C. elevating the lower extremities and giving antivenin.
D. supine positioning, splinting the leg, and transporting.

Answer: D Question Type: Critical Thinking Page: 1090

61. You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient’s vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient’s presentation, you should suspect:
A. Lyme disease.
B. an allergic reaction.
C. exposure to poison ivy.
D. Rocky Mountain spotted fever.

Answer: A Question Type: Critical Thinking Page: 1091

62. A 48-year-old male was stung on the leg by a jellyfish while swimming in the ocean. He is conscious and alert, but complains of intense pain at the wound site. Specific treatment for this patient includes:
A. irrigating the wound with vinegar and immersing his leg in hot water.
B. pulling the nematocysts out with tweezers and bandaging the wound.
C. immersing his leg in fresh cold water and scraping away the stingers.
D. applying a chemical ice pack to the wound and encouraging movement.

Answer: A Question Type: Critical Thinking Page: 1091-1092